My last post about Doctors and Guns definitely generated some interesting comments. I really enjoyed reading the different perspectives and want to thank all readers for their comments. It has made me realize that this blog can be much more interactive and thus I will try to provide more stimulating posts. It has also made me realize that I need to watch carefully what I write here — so many of you quoted the post verbatim it’s a good thing I did not say anything too stupid!

I’ve decided to go ahead and start a new series of posts about patients and what they want, expect, and deserve from their doctors. A few comments from my previous posts about the changing physician workforce as well as the Medicine and the Law series made me realize that each one of us is a patient and so many blog posts are about medical topics and issues but not about the patients.

I’m calling this the Patient Manifesto series and we will begin with the question:

What do you want, expect, and deserve from your doctor?

I know this is a very broad question so I will start with these categories — personality, education, accessibility, management style, cost. I encourage everyone to comment and every few weeks or so I will update our Patient Manifesto of things that we care about or we should consider when we choose physicians. Here are some things that we can start with. If you want to comment or bring up other categories that would be great.

Gender – It really does not matter to me whether it is a male or female physician.

Personality – It really does not matter to me the exact personality of my doctor as long as he is kind and compassionate. If he is serious or the joker type, it’s not that important to me because it’s not like I am choosing a friend. I need someone who is genuine and likes his/her job.

Education – It does not matter to me whether my doctor is US educated or from another country. I think reputation is more important than education. I usually will go with whomever my primary care doctor refers or who other doctors think highly of.

Accessibility – I want my doctor to be accessible at all reasonable hours but not all hours of the day or night. I want to be able to get in to see my doctor within a week or two. If I have to wait more than 2 or 3 weeks, that is unacceptable to me and I would be willing to see someone else. I also don’t want to have to drive to another town to see a doctor, unless I have a special problem that warrants this specialist.

Management Style (Conservative or Aggressive) — The majority of health problems I have experienced are related to athletic or workplace physical injuries from overuse. My general beliefs about overcoming injuries is to be conservative and not too aggressive because I don’t want to make the injury worse and I don’t want to extend my time of inactivity. Thus, I tend to feel more comfortable with doctors who are conservative in their management of injuries.

Cost – I have insurance and thus I have to see doctors that accept insurance. Other than that, health is very important to me so cost such as co-payments and all that stuff are not a consideration.

Disciplinary Action – I do not have any clue as to whether my doctors have ever had any disciplinary or legal action taken against them. Perhaps it is because I am a doctor or maybe it is because I tend to go to doctors through referral.

Gender: If I’m going to a doctor for something female related, I prefer a female doctor.

Personality: Nice, understanding.

Education: Never thought about it before. I’ve never actually checked to see where any doctor I’ve gone to went to school, although maybe I should. US or not – see below.

Accessibility: A 2 or 3 week wait is fine for check-ups, but if I’m sick I want to be able to see them within 24 hours, usually. If I have something minor to ask, its nice to be able to talk to a doctor on the phone briefly or at least be able to relay a message through someone – as long as I feel my privacy is respected by that person.

Management Style: I haven’t had anything too seriously wrong to really be able to answer this. But I think I would like them more aggressive if there is a possibility of something seriously wrong.

Cost: I have good insurance, but I am intrigued by medical practices that aren’t taking insurance any more. Don’t know if I could afford it though.

Disciplinary Action: I wouldn’t know how to find out this information about a doctor, but it is something I would like to know.

Other: I prefer a doctor I feel I am able to communicate clearly with, so having English as their first language can be helpful, although as long as I can understand what they are saying to me and I think they understand me also – that’s the important thing. I am sometimes concerned about cultural differences – which could lead to misunderstandings. And I also have some concern about a male doctor from a area or culture that doesn’t tend to respect women’s rights.

In general, I want a doctor that I feel I am able to work together with to keep me as healthy as possible. One who respects me and sees me as an equal human being. I have a science background and I don’t appreciate being talked down to by doctors. I would absolutely love a doctor who could give me copies of research articles or reviews about health topics I am interested in and who would discuss the latest research with me.

Sibyl

Gender: I nearly always prefer male doctors to female doctors. I’ve been burned by too many female doctors cutting back their practice hours in order to raise young kids or leaving me with another doctor while they go off on maternity leave. A consistent relationship with my doctor is required. I do not trust easily.

Education: I do not want to see any doctor who received their degree in the 90’s or later. The newly-minted doctors are too lifestyle-oriented. They’re the kind who are likely to take long vacations and refuse to be available to their patients. They’re also likely to over-treat me in order to squeeze extra money out of my HMO.

Personality: Intelligence should be self-evident in the way my doctor speaks. My doctor should be willing to listen to me fully. My doctor should also give me the benefit of the doubt, as I am the only inhabitant of my body and therefore I am the only one who knows what feels “wrong”.

Accessibility: If I am sick, I want to see my doctor the same day or the next day. It would be nice if my doctor offered extended office hours a couple days a week. If I have very important questions, I’d prefer to speak to my doctor and not an “on call” doctor who has never met me before.

Management Style: If it’s nothing major, I just want some reassurance that it’s going to go away soon, and maybe some help with the symptoms while I wait. If it is something major, I’d like for the doctor to do as much as possible, and quickly. I don’t like playing office and phone tag over the course of two months with my PCP and specialists.

Cost: I’d prefer to have the least expensive treatment that does the most good, unless I’m allergic to it or something.

Language: I am only willing to see doctors who speak understandable English. I lived outside the US for many years and the language barrier got me into trouble too many times, even though they spoke English and I spoke the native language. Shades of meaning get lost in translation when non-native speakers collide. I wound up grossly under-treated for severe pain. I also do not want to struggle to understand heavily-accented English. I have grown weary of that game. I just want to be heard and understood — and be able to hear and understand.

Gender: I am female but I have been burned several times by incompetent, uncaring and unkind female physicians. I don’t know what their issures are, too much on their plates I think. Sadly, I have given up on them. My new pcp is a nice male.

Personality: I don’t care about his personality, as long as the job gets done. Niceness on his part is icing on the cake though.

Accessibility: A couple of weeks for routine things is okay. With my medical group I can go to Urgent Care and there is always the E.R. I always try to be brief during an office visit, but sometimes even when a physician is in the same room as me I get the feeling he is actually mentally with his next patient. Making more money, dollar signs. That can be so irritating. He can be physically there but yet not accessible. I might have waited a month for an office visit and have a written list of questions, medications to go over, etc. I don’t feel 15 minutes is long enough for most visits. 20 minutes should be minimum. When I see a physician in his office I want his full attention. Sit down. Look at me. Listen. I, for one, don’t do idle chatter. I can learn something from you but also, you just might learn something from me too.

Education: I always try to Google a new physician to see where they went to school. I kinda do prefer someone who was educated awhile ago (not real old so as to be out of date but not so young he is the new arrogant type) so I know he has solid experience. I think they go hand in hand.

Personality: I don’t care if he makes small talk or not. I am more concerned with things other than his personality. I hire him to do a job, get me well and get me out of there.

Management Style: I like a physician who asks my opinion about my medical care. I never tell a physician that I am a nurse. I do like to participate in my care. I had a biliary sphincterotomy once and asked a physician about a pancreatic sphincterotomy and he asked, sincerely, if I thought it would be a good idea. I said I didn’t know and would like more information about it and we had a good discussion. I really appreciated his asking me what I felt I needed or wanted.

Language: I had a negative experience once with a surgeon who spoke English as a second language and spoke poor English. He took his residency in the U.S. and he came highly recommended but I should not have gone to him. When I’d talk to him he just didn’t get concepts. Now I don’t go to any physician whose English is not flawless. I think they might have passed the appropriate tests to pracitice medicine here but might not really understand the concepts. My current pcp was born in Asia but speaks perfect English. I am very happy with him. He gets it.

Disciplinary Action: This is one item that I would like to see improvement on. As a patient I feel a great need to know more about the physicians I must see. I would like to have instant and easy access to see the legal side of their disciplinary actions. I saw a fantastic surgeon two years ago who had some whistle blower issues and went to him anyway, I respected him. They know a whole lot about me, I am open and honest. I need to know more about them.

brooklyndo2

To patients, as a patient and doctor:
While I agree with many comments so far, I would like to put up some topics/ points to think on for others:
1. In my medical law class in school (a very brief one) , one of the things the professor, who is an RN / JD stated “If there is one thing I want you to get out of this class as a concept is that as a physician you have responsibilities but NOT rights”
2. sybil’s statement
“Education: I do not want to see any doctor who received their degree in the 90’s or later. The newly-minted doctors are too lifestyle-oriented. They’re the kind who are likely to take long vacations and refuse to be available to their patients. They’re also likely to over-treat me in order to squeeze extra money out of my HMO.”
– younger physicians like myself have been trained in a litigation happy environment, have seen tremendous pay cuts and would like a modicum of private life. Let the flaming ensue
I would love to be available to all my patients 24 hours per day. Unfortunately , I do have to sleep, and some patients do not understand that (my experience) With current HMO regs/contracts, if a small part of my patients would call me with all their concerns all the time, I would not be able to see those who made appointments. Some sort of system such as email questions etc could be done, and questions answered. If a patient has a serious concern in the middle of the night, a visit to the ER may be appropriate.. after all it is an emergency to them and I am not an ER doc. I think if people took a stand with their health care payers (insurance) and refused to pay premiums unless member physicians got paid adequately for the procedures they do, and for the thought and training that goes into being a doc in the first place, allowing us the knowledge to make decisions, then maybe your doc would not have to see 60 patients a day to keep the office open in order to be able to provide some kind of care.
As for insurance denials and other games they play with what we as physicians and we as patients need in order to make informed decisions , well I think that deserves a whole other series.
flame away!

About Us

Founded in 2005 by Dr. Shaheen Lakhan, Brain Blogger is an official undertaking of the Global Neuroscience Initiative Foundation (GNIF) — an international charity for the advancement of neurological and mental health patient welfare, education, and research. It is one of the most effective mediums for the GNIF to raise awareness of neuro-related topics.